Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome : An exploratory analysis of the KANON trial

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Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome : An exploratory analysis of the KANON trial

Filbay, Stephanie R. (författare): University of Oxford

Roos, Ewa M. (författare): University of Southern Denmark

Frobell, Richard B. (författare): Lund University,Lunds universitet,Lund OsteoArthritis Division - Joint injury research group,Forskargrupper vid Lunds universitet,Lund OsteoArthritis Division - Nedbrytning av ledbrosk: en biologisk process som leder till artros,Lund University Research Groups,Lund OsteoArthritis Division - Molecular marker research group

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Roemer, Frank (författare): Lund University,Lunds universitet,Lund OsteoArthritis Division - Joint injury research group,Forskargrupper vid Lunds universitet,Lund University Research Groups,Boston University,Friedrich-Alexander University Erlangen-Nürnberg

Ranstam, Jonas (författare): Mdas AB

Stefan Lohmander, L. (författare): Lund University,Lunds universitet,Lund OsteoArthritis Division - Nedbrytning av ledbrosk: en biologisk process som leder till artros,Forskargrupper vid Lunds universitet,Lund OsteoArthritis Division - Molecular marker research group,Lund University Research Groups

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2017-05-17
2017
Engelska.
Ingår i: British journal of sports medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 51:22, s. 1622-1629

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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Aim Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured individuals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. Methods Exploratory analysis of the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial (ISRCTN84752559). Relationships between prognostic factors (baseline cartilage, meniscus and osteochondral damage, baseline extension deficit, baseline patient-reported outcomes, number of rehabilitation visits, graft/contralateral ACL rupture, non-ACL surgery and ACL treatment strategy) and 5-year Knee Injury and Osteoarthritis Outcome Score (KOOS) pain, symptoms, sport/recreation and quality of life (QOL) scores were explored using multivariable linear regression. Estimates were adjusted for sex, age, body mass index, preinjury activity level, education and smoking. Results For all participants (n=118), graft/contralateral ACL rupture, non-ACL surgery and worse baseline 36-item Short-Form Mental Component Scores were associated with worse outcomes. Treatment with exercise therapy alone was a prognostic factor for less knee symptoms compared with early reconstruction plus exercise therapy (regression coefficient 10.1, 95% CI 2.3 to 17.9). Baseline meniscus lesion was associated with worse sport/recreation function (-14.4, 95% CI -27.6 to -1.3) and osteochondral lesions were associated with worse QOL (-12.3, 95% CI -24.3 to -0.4) following early reconstruction plus exercise therapy. In the same group, undergoing additional non-ACL surgery and worse baseline KOOS scores were prognostic for worse outcome on all KOOS subscales. Following delayed reconstruction, baseline meniscus damage was a prognostic factor for less pain (14.3, 95% CI 0.7 to 27.9). Following exercise therapy alone, undergoing non- ACL surgery was prognostic for worse pain. Conclusions Treatment-dependent differences in prognostic factors for 5-year outcomes may support individualised treatment after acute ACL rupture in young active individuals.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Physiotherapy (hsv//eng)

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Av författaren/redakt...: Filbay, Stephani ...; Roos, Ewa M.; Frobell, Richard ...; Roemer, Frank; Ranstam, Jonas; Stefan Lohmander ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Ortopedi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Hälsovetenskap; och Sjukgymnastik

Artiklar i publikationen: British journal ...

Av lärosätet: Lunds universitet

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